24 June 2013

Natural born worrier

OCD is an anxiety disorder and an anxious temperament can make you more vulnerable to developing the condition. I've always been a worrier, and worrying - and the uncertainty that provokes it - contribute to my need for control. The more I can control, the calmer I feel.

I realise that always being anxious is an incomprehensible state of being for those of you who aren't born worriers, and who only have sleepless nights when you really have something to worry about.

For those of us for whom worrying is like breathing, not worrying is equally incomprehensible.

My anxiety takes many different forms: from mulling over unpleasant incidents and worrying about a challenge to be faced, to imagining full-scale disaster and tragedy, often on the basis of very little.

I once found a lump in my left forearm while bathing; a definite lump, no figment of a hypochondriac's imagination. By the time I'd finished my bath, I'd projected forward to a diagnosis of cancer and the amputation of my arm, I'd learnt to write again with my right hand and entered the Paralymics as a one-armed archer. All in the space of 10 minutes. A visit to the doctor revealed that it was a harmless cyst.

Image courtesy of: Stuart Miles/
Likewise, my boyfriend and I, who live in separate flats, speak every night at 10pm. If he doesn't pick up, or return my message within seconds, I don't assume that he's on his mobile, or lost track of time in the bath, I conclude that he's dead from an ruptured aneurysm. In the two minutes between leaving my message and him calling me back, I've buried him, grieved for him and found a new partner. 

And all the time I'm worrying, I'm experiencing the physical effects of anxiety, as well as the mental and emotional ones. Depending on the level of worry, this can include a churning stomach, racing heart or dizziness. It's a draining way to live.

When I'm particularly anxious, I'm driven into a frenzy of ordering. 

My boyfriend called late one evening to say that the electricity had gone off in his flat. My concern as to the implications for him - his freezer defrosting, the hassle of getting in an electrician, the cost of repairs etc - sent me spinning off around my own flat to check that everything was in its place. Ordering created an illusion of control in a situation where I was, in fact, more or less helpless. It was only when he texted a little later to say the power had come back on of its own accord, that I could let go of my OCD comfort blanket.

Someone once said to me 'Worrying is like a rocking chair, it gives you something to do, but it doesn't get you anywhere.' My OCD compulsions are much the same.

* * *

Are you a worrier? If so, how do you manage your anxiety?

17 June 2013

Annus horribilis

The Queen declared 1992 an 'annus horribilis' for her. My own 'horrible year' came two years later and was also when my OCD first became an issue.

That year I experienced redundancy, marital difficulties leading to separation - and ultimately divorce - and, as a result of that separation, a house move. On 4 February 1994, I was made redundant. On 4 February 1995, I moved into my new flat. Three major upheavals in the space of a year - the stress had to manifest itself somehow and, for me, it was in OCD.
Photo: Peter Gettins Photography

The condition had, in fact, begun while I was still with my ex-husband, no doubt as a result of my increasing unhappiness. 

He left for work before me and came home after me, giving me time to put things right in our flat, ie to apply my rules of order and symmetry. From the moment he returned, he'd gradually undo my work, but I'd just bide my time until his next absence to reinstate my patterns. At least I could leave for work with the flat perfect and know that it would be the same when I got home. Weekends presented a problem, but, at that stage, I could tolerate the 'mess', provided I could fix it in the short term.

I'm still friends with my ex and he's told me that he had no idea I was doing all this. To him, the flat simply looked tidy; he didn't notice the precision with which I placed objects. And I certainly never let him witness the effort it took.

Looking back, it seems logical that I felt the need to exert control in my life in response to the events I'd experienced. The key elements of my world - relationship, home and job - had all crumbled. I could no longer be sure of stability in those areas, so I created it where I could: in my immediate environment.

When I finally moved into my flat, I thought I'd be able to stop. With no one to disrupt my surroundings, surely there would be less for me to do? The opposite proved to be true. Now that I had my own sanctuary against the world, I was driven to preserve its status quo. It quickly reached the point where I wouldn't have anyone else in my home. I was concerned not only that they'd move things, but that I'd have to, to accommodate them and provide the requisite hospitality. Even the idea of moving a chair from one room to another was traumatic.

That was when I realised I needed help. 

I was fortunate that my GP provided a sympathetic ear. In those days there was even more stigma, and much less openness, about mental health issues. Nor were there yet any NICE guidelines* to steer her, or me, in my treatment.

Nevertheless, so began the journey to recognising, understanding and tackling my condition.

* * *

*National Institute for Health and Care Excellence (previously known as the National Institute for Clinical Excellence): OCD guidelines at http://www.nice.org.uk/CG31

10 June 2013

How clean is my house?

I've always taken a perverse pride in telling people that, although I have OCD, I hardly ever clean. My form of the condition is focussed on a need for order and symmetry in my environment, rather than keeping it pristine. 

Acquaintances are surprised by this. They see how tidy I am, and the way I fiddle about rearranging things, and assume cleaning is intrinsic to this behaviour. 

Friends who have visited my flat are even more surprised: people see tidy and think 'clean'.

The reality is - brace yourselves - I only clean about once every 3-4 months. 

That might sound slobbish, but I live alone and don't wear my shoes indoors, so the dirt is pretty much limited to dust. And, as Quentin Crisp said, 'After the third year, the dust doesn't get any worse.' The number of years quoted varies from source to source, but I can vouch for its truth over a shorter time frame. A week after cleaning, a film of dust will be visible. A month - or two, or three - later, it's not much worse.

Photo: Peter Gettins Photography
I empty the bins and wipe down the bath after use, but that's about it. Definitely no dusting or vacuuming, unless absolutely unavoidable. Unavoidable includes Christmas: even I'm not prepared to live ankle deep in tinsel strands and pine needles until March.

I've realised recently, though, that my aversion to cleaning isn't proof of some kind of 'normality', counter-balancing my OCD. It is, in fact, a direct result of my particular form of the condition.

In order to clean, you have to move things. I don't mind moving my belongings, so long as I can easily put them back in their place. And provided other items remain around them, this is as simple as removing a single piece from a jigsaw: you can see exactly where to replace it. Move everything, though, and it's like dismantling the whole puzzle: you're back to trying to create a shape out of nothing but scattered pieces.

Cleaning is undoubtedly boring and time-consuming, but now I know that the destruction of my patterns is the real deterrent to getting out the duster and vacuum cleaner.

In future, I won't be quite so smug about my lack of cleaning. The only thing it actually demonstrates is yet another way in which OCD's tendrils choke me.

3 June 2013

A matter of time

Two of the key elements in differentiating someone who has OCD from someone who doesn't - but who may exhibit OCD-style behaviours - is the degree of distress their compulsions cause them and the amount of time they spend on them.

Professionals in the field regard someone as 'cured' if their compulsions occupy no more than an hour a day. That might sound a lot, but many sufferers - pre-treatment - spend every waking moment on them. For people with such extreme OCD, reducing the time lost to compulsions to an hour or less a day is a great achievement. 

But think about what else you could do with that 365 hours a year - not forgetting the bonus hour in leap years. I love reading and, at the speed I devour books, could get through an extra 36 300-page novels. Or maybe even write another one.

Photo: Peter Gettins Photography
So how long do I spend on my compulsions? Even at my worst, 18 years ago, it would have been hard to quantify, as they've always been so integral to everything I do. Most add only a few seconds to a task, such as when I unplug the TV and put the plug on the floor: it takes only a fraction longer to ensure it's lying parallel to the skirting board.

On the other hand, putting away clean or ironed clothes - usually a once a week job - can take 30-45 minutes. I have to fold items a certain way and ensure that there are no wrinkles in them, then lay them squarely on top of one another in the drawers. I hang clothes in the wardrobe in categories, with the arms folded in neatly, and adjust the hangers to face the same way, and to sit straight on the rail without touching each other. I'd guess most people could do the same job in 5-10 minutes.

The professionals' target of an hour gives me 360 seconds to play with, but an extra 2 seconds here and 5 seconds there, dozens of times a day, quickly eats into that 'allowance' - never mind the whole minutes I fritter away on bigger chores. My sense is that I probably do spend at least an hour a day on my compulsions. I certainly seem to accomplish less in my spare time than other people.

And even if my OCD behaviours do fall within that time frame, I'll never see myself as cured. I'll always have the condition, but sometimes I'll manage it better than others. It's a little like being a recovering alcoholic. You have to keep fighting the battle every day.